A Moonshot for the 21st Century

During his final State of the Union address, President Obama announced that he was appointing Vice President Joe Biden to head a new initiative to cure cancer. The goal of this new “moonshot” is to “accelerate our efforts to progress towards a cure, and to unleash new breakthroughs for other deadly diseases.” Achieving these goals will be difficult, but the need for a cure is abundantly clear. According to the Center for Disease Control, cancer is the second leading cause of death in the United States, with over 1.6 million new cancer diagnoses and almost 600,000 deaths due to cancer in 2015 alone. President Obama poignantly expressed the need for scientific advancement in cancer research “for the loved ones we’ve all lost, for the family we can still save, let’s make America the country that cures cancer once and for all.”

The Office of the Vice President has since assembled a Cancer Moonshot Task Force that convened for the first time on February 1st. This committee brings together numerous executive branch departments and agencies, including the National Institutes of Health, National Cancer Institute, Department of Defense, Department of Energy, Department of Veterans Affairs, and many more. With the help of oncologists, cancer researchers, and advocates, the committee will help direct federal investments towards fighting cancer. After the meeting, Dr. Francis Collins, director of the National Institutes of Health, and Dr. Douglas Lowy, acting director of the National Cancer Institute, took to Twitter to continue the conversation. Collins and Lowy answered questions regarding the focus of this initiative and reiterated the Vice President’s call for a comprehensive approach to bring “all the cancer fighters together.”

Like the first moonshot to land a person on the moon, this announcement echoes the call for innovation from both the public and the private sectors. Biden’s plan to double the rate of progress largely rests on increasing clinical trial participation and advancement of new, cutting-edge approaches to cancer treatment, such as re-directing a patient’s own immune system against their tumors. Biden noted that “we’re at an inflection point – and the science is ready.” With approximately 5 percent of cancer patients enrolling in clinical studies, this is one potential pathway to increase involvement of cancer patients and survivors to better understand the disease. Biden has indicated that prevention and earlier detection will also be priorities. Other research opportunities include cancer vaccines and generation of therapies that target specific mechanisms utilized by tumors. He also hopes that by facilitating data exchange and encouraging communication between cancer centers, more researchers can capitalize upon the vast sources of data currently available.

This is not the first time a president has called for a cure for cancer. In 1971, President Richard Nixon called for a “War on Cancer”. This effort led to The National Cancer Act, which allocated special budgetary authority to the National Cancer Institute. Many hoped that a cure could be identified by understanding the underlying cause of cancer, but ultimately, the war has not been won. We have learned much about cancer since 1971, and it is now well accepted that cancer is not a single disease, but rather a collection of many diseases, even hundreds, with a wide range of causes. In a recent Q&A that Joe Biden hosted on his Facebook page, he even acknowledged that “multiple disciplines are needed to attack this disease.” Now that the complexity of cancer is better appreciated and it is clear that an individualized approach will be necessary, the Cancer Moonshot hopes to take advantage of a multidisciplinary approach, including genetic analysis of individual tumors, to keep the momentum going. With new studies like the NCI-Molecular Analysis for Therapy Choice (NCI-MATCH), great efforts have been put forward to find the right drug(s) that will target the right disease based on molecular characterization. Additionally, Lowy announced that a pediatric version of the NCI-MATCH trial is set to start later this year.

While reinvigorated efforts to improve cancer treatment sound promising, this new initiative faces many challenges. The White House has requested that an additional $1 billion be allocated to increase resources. The White House also announced that $195 million will be immediately available, but it is not yet clear if this money will come from a reallocation of funds in the FY2016 budget. And with less than a year left of Obama’s presidency, many worry that this initiative may not be sustainable. Indeed, although Biden has indicated that he plans to propose continuing support for the Cancer Moonshot in the FY 2017 budget, he will no longer be in office to help direct the use of those funds.

“Now, as I’ve said from the start, I don’t claim to be a cancer expert,” admits Biden, “but I do have something to offer when it comes to being a catalyst and bringing folks together.” The resulting concerted effort by government, private, and public sectors aim to do the unimaginable – cure cancer. The original moonshot brought diverse groups together to achieve a seemingly impossible goal to walk on the moon, but only time will tell the success of this moonshot.